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Nursing homes will not be expected to turn their staff members into vaccine experts under a new rule that requires all workers to be offered COVID-19 shots and to be educated about them, a federal official said Thursday. The interim rule goes into effect today, with enforcement starting June 13.

In addition, providers will not be penalized if they can’t actually offer vaccinations, as long as they are able to show documentation that they tried to acquire them.

Even just a single educational opportunity per worker should satisfy surveyors as they begin to enforce the rule’s vaccine education component, said Holly Norelli, branch manager for oversight and transparency at the Centers for Medicare & Medicaid Services.

“We don’t expect that surveyors are going to walk up to a nursing assistant and say, ‘Hey Kimberly, tell me everything about the COVID vaccine. What does it do, and what are all the risks and benefits?” Norelli said during a LeadingAge COVID-19 conference call. “We just want to see that the effort has been made.”

On May 11, CMS announced an interim rule requiring long-term care facilities to report staff and resident COVID-19 vaccinations to the National Healthcare Safety Network weekly and to educate both residents and staff about the available vaccines. It goes into effect today, while enforcement will begin the week of June 13, according to the head of the CMS Division of Nursing Homes.

Under the rule, education must cover the benefits and potential side effects of the vaccine to include common reactions, such as aches or fever, and rare reactions such as anaphylaxis. In a previous memo, CMS listed several resources that could be used to develop education policies and keep information flowing to staff and residents, Norelli noted. Those include online information from the Centers for Disease Control and Prevention.

Record efforts to educate

She added that providers could fulfill the requirement to educate staff by presenting that material or printing it out to provide to workers. But they need to document those efforts with employee acknowledgement. Norelli said a sign-in sheet would suffice.

Providers’ documentation also must capture the date of the education and samples of the educational materials.

Norelli, a former nursing home administrator who joined CMS mid-pandemic, urged “prudent” leaders to make routine attempts to update staff, particularly vaccine-hesitant workers, about new vaccine information and to share why vaccination helps residents.

She said the approach could be similar to the one she used when encouraging workers to be vaccinated against the flu. She could not answer whether CMS might eventually mandate that facilities report flu vaccination among staff, but did add that the agency only “implements requirements when there appears to be a strong need.”

Norelli and other CMS officials have said they will use vaccine and education reporting to monitor and provide additional support to providers who struggle to improve vaccination rates. After facilities begin documenting the vaccination status of each staff member, the information also will be posted on the public COVID-19 Nursing Home Data website — as early as mid-June.

In related news, Norelli said providers who document attempts to secure vaccines from pharmacies and local health partners — even if they’re unsuccessful in getting shots in a timely manner — would be considered in compliance with the requirements to offer vaccines.

“We are hearing that these (access) challenges remain,” she said. “Facilities will not be penalized if they are doing these things.”